We haven’t lost our healthcare yet
The AHCA has passed the House, but it’s a long, long way from the finish line.
While House Republicans ran to the Rose Garden for a victory lap after Thursday’s passage of the controversial American Health Care Act (AHCA), tens of millions of Americans were left worrying about what’s next.
For many, it was jarring to watch a group of individuals with some of the best employer-provided healthcare that money can buy ram through a bill that puts affordable healthcare access at risk for a large portion of the country, despite the majority of the Republican caucus not having read the bill and many clearly not understanding how key, controversial components of their own plan would work. We still have no idea what the exact financial or human cost of this plan would be if implemented, because the GOP didn’t allow time for the Congressional Budget Office to conduct and release an official assessment.
Over the past 48 hours I’ve had dozens of conversations with people who are overwhelmed with worry for their own health, a friend’s health, or a family member’s health. They are scared. House Republicans had 7 years to formulate a better option than the ACA, and failed. In the meantime, they did nothing to work with Democrats to address the ACA’s challenges and to prevent the exodus of insurance providers states like Iowa are currently experiencing. The added uncertainty created by the GOP’s repeat pledges and failures to produce a replacement has likely accelerated those trends, and the current uncertainty over the AHCA will only pile on. As of March, House Republicans couldn’t even get enough members from their own caucus on board with the AHCA to hold a vote. Their latest attempt was so disingenuous, haphazard, and rushed that right up until Wednesday night, they still didn’t have the votes they needed. Major medical associations across the country, from the AARP, the American Nurses Association and, yes, even the American Medical Association, have denounced the plan. House Republicans even tried to exempt themselves from their own healthcare bill. And yet we’re supposed to believe this is a “great deal” for the rest of us?
Every conversation I’ve had about the AHCA vote has boiled down to one sentiment: people are feeling overwhelmed and disempowered. Even more so because, for many, healthcare access is literally a matter of life-and-death.
But here’s what the vote on Thursday didn’t do:
It didn’t make the AHCA the law.
So what happens next?
With the AHCA through the House, it moves on to the Senate, where it’ll face fierce opposition from both sides of the aisle. The $800 billion in cuts to Medicaid and roll back of the ACA’s Medicaid expansion will be key sticking points. Multiple Republican Senators have confirmed to reporters that they already have amendments in the works. Since the Senate won’t pass the bill in its current form, it’ll get marked up and returned to the House, where Republican leadership barely wrangled enough votes to ram it through on Thursday by a 4-vote margin. It’s still far from clear what kind of arm-twisting went on Wednesday night to reel in those deciding votes, but all signs point to even minor changes from the Senate becoming points of contention when the bill returns to the House.
In the meantime, Senate Republicans will be watching like hawks to see what kind of blowback their House counterparts get for voting to pass the AHCA. The greater the blowback, the more hesitant they’ll be to vote for the bill without substantial changes, if at all.
In the House, 14 Republicans who voted for the AHCA hail from districts Clinton won. 19 originally opposed the bill:
And in the end, 20 Republicans still voted no. Some hard-liners like Andy Biggs (R-Az.), who claims he can’t support “anything less than a full repeal,” obviously aren’t allies to progressives but they are hardly going to be satisfied by the inevitably more moderate version of the bill that the Senate kicks back. Others, like Meehan (R-Pa.) and Reichert (R-Wa.), were reportedly on the fence through Wednesday night and, despite attempts to win their votes over, ultimately voted no anyway due to concerns over the Medicaid rollbacks and threats to those with preexisting conditions.
We have a window, right now, to affect real and measurable change. The House just began an 11 day recess, meaning the vast majority of members will be in their home districts. How did your representatives vote? Does s/he have a town hall planned? If yes, show up and tell them what you think. If not, call their offices and find out why — or, if you can manage it, show up in person to voice your concerns and tell your stories. If you’re ready to kick your representative out of office for this vote, find out whether anyone else has announced that they’ll be mounting a 2018 challenge in your district. Learn about them. If you like them, voice your support and/or contribute to their campaigns.
What happens in the next few weeks will set the tone for the Senate, which will determine just how long we have to keep fighting and exactly how far the Senate Republicans will be willing to go. The more moderate the bill becomes through Senate amendments, the less likely hard-line conservatives will still be on board when it gets back to the House.
The fight isn’t over — it’s just beginning.
The GOP has finally laid their cards on the table. Now we know exactly what we’re fighting against.
This is the time to make our voices heard. The stakes are high, but our leverage is greater than we think.
